Frequently Asked Questions

Only if the physician you are seeing for your injury tells you the job is safe to perform in your condition. You should alert your physician if you feel unable to work and follow his or her advice to protect your physical health. Explain to your physician in detail what your job duties require and why you feel you are unable to perform those duties. There is a substantial amount of case law and several rules that govern the return-to-work process. This is a critical part of your workers’ compensation case that can seriously impact your claim and your ultimate financial recovery. Consulting an attorney regarding these issues is highly recommended before you make decisions about return to work.

In the majority of cases, you are eligible to receive payment for medical care and lost wages at 2/3rds your average weekly earnings, including overtime and bonuses (often called “TTD”), in the year prior to your date of injury. You may also be entitled to compensation for permanent disability, often referred to as a “rating.” You are not entitled to recover pain and suffering under workers’ compensation laws.

Your weekly checks are calculated by averaging your wages in the one year prior to your date of injury. You are then eligible to receive two-thirds of this amount for any week that you miss work due to your work injury. The insurance company must take into account overtime and bonuses when calculating your weekly benefits. The insurance company will refer to your weekly check as “TTD” which stands for “temporary total disability.” There is a 7 day waiting period before your weekly benefits are due to start. If you are out of work for more than 21 days, then you are eligible to be reimbursed for the 7 day waiting period.

In most instances, so long as you sustain a new compensable injury, you are entitled to receive Workers’ Compensation for your injury despite having a prior claim. There are potential prohibitions on recovery if you misled your employer about a prior injury.

You are entitled to workers’ compensation benefits even if you are an undocumented worker. Your employer can terminate you if it discovers you are undocumented, but the workers’ compensation insurance company cannot deny your claim based on your immigration status alone.

The insurance company must provide an interpreter if the doctor’s office does not have someone on staff who speaks your language. The interpreter must be someone other than your nurse case manager if you have one assigned, as you are entitled to private examinations with your physician prior to your nurse case manager entering the room.

You are entitled to workers’ compensation benefits even if you were paid cash by your employer. However, it may be challenging to prove the amount you were being paid by your employer. You have the burden of proving your wage earnings prior to your date of injury.

There is a settlement at the end of most cases. The amount depends on a variety of factors which include your wages and the extent of your injury. Of course, it is imperative that you consult an attorney prior to settlement, as you may be paid too little on your case without proper representation.

Injured workers often feel that they do not need an attorney if their medical bills and weekly checks are being paid by the workers’ compensation insurance company or their employer. However, in a compensable workers’ compensation case, the insurance company is obligated to meet these basic requirements and is not doing you a personal favor. The insurance company and your employer will not protect your rights. Insurance companies are in the business of making profit, not protecting injured workers. You may never get a fair settlement and your rights may not be properly protected without legal advice. We are in the business of protecting you and your family when you are injured on the job.

Choosing a North Carolina State Bar Board Certified Workers’ Compensation attorney is the only way to ensure you have a true expert or “specialist” in the field of Workers’ Compensation. All attorneys who handle workers’ compensation cases are not specialists. Specialists must meet specific rigorous criteria and testing in order to be called a “specialist” by the North Carolina State Bar. Being a specialist places the attorney in an elite field in the particular area of the law for which they are certified.

Your initial consultation is free. Workers’ compensation cases are handled on “contingency fee” basis. This means that your attorney will take his or her fee as a percentage of your settlement. The law in North Carolina generally restricts an attorney from charging more than 25% of your settlement or award. You are still responsible for any costs associated with obtaining the settlement or award, such as the out-of-pocket fees the attorney will incur for gathering your medical records. These costs are in addition to the attorney’s percentage fee. Generally these costs are reimbursed to the attorney out of the settlement proceeds.

The best way to determine the answer to this question is to speak with a Workers’ Compensation Specialist. Generally speaking, if your employer has three or more employees, you may be eligible for workers’ compensation benefits. You may be covered regardless of your immigration status. North Carolina’s workers’ compensation laws cover injuries that result from an accident arising out of and in the course of employment. The law also covers “occupational diseases,” which include some lung conditions such as asbestosis or silicosis, and some repetitive-motion conditions, such as carpal tunnel syndrome. Your injury will have to fit the very specific legal definition of a covered injury under applicable law. You are eligible to recover compensation even if you are at fault in the accident. In most cases, your sole remedy for on-the-job injuries is through the workers’ compensation system.

Caution, this is not a good idea, because workers’ compensation laws cover your medical care and lost wages and possibly additional benefits by way of a settlement at the end of your case. It is always best to have your claim reported to the insurance company so that you are protected. The insurance company has a right to timely investigate an injury claim and may deny your claim down the road if it is not properly reported. There is also a risk that your employer may fire you, demote you, or take other adverse action against you. If your employer does take such adverse action, you should contact the North Carolina Department of Labor.

File a written report of injury, ideally a Form 18, with the NCIC within 30 days of your injury or accident. There are some limited circumstances under which the NCIC can excuse late filing. Note that different rules apply with occupational disease claims rather than injury by accidents.

North Carolina is an employment-at-will state. Your employer does not need “grounds” to terminate you. Therefore, your employer can terminate you while you are out of work for a work-related injury, or after you have an injury at any point. It is illegal for you to be terminated because you file a workers’ compensation claim, but proving this is the reason for termination is not an easy task. In many instances, individuals do get terminated, or “dropped from the books” as an employee, after being out of work for a period of time in a workers’ compensation claim.

If your claim has been accepted as compensable by the workers’ compensation insurance company, the insurance company has the right to direct your medical care, which includes choosing your physician. However, there is a statutory provision which allows you to seek an independent medical evaluation either by agreement with the insurance company or by motion at the North Carolina Industrial Commission. You are also always entitled to a second opinion on your “permanent partial disability rating” or “PPD” if you are assessed such rating.

If your doctor’s appointment is more than 10 miles one way (20 miles roundtrip) from your home, then you are entitled to mileage reimbursement at a set rate. If you do not have transportation, the insurance company must arrange for a car to transport you to and from your doctors’ visits.

Workers’ Compensation Links

North Carolina Industrial Commission

The Industrial Commission administers the Workers’ Compensation Act, the Tort Claims Act, the Childhood Vaccine-Related Injury Act, the Law Enforcement Officers’, Firemen’s, Rescue Squad Workers’ and Civil Air Patrol Members’ Death Benefit Act, the Act to Compensate Individuals Erroneously Convicted of Felonies and the Eugenics Compensation Program. Our mission is to ensure all parties are treated fairly and equally in accordance with North Carolina State Law. Visit site

NC Department of Vocational Rehabilitation

The Division of Vocational Rehabilitation Services provides counseling, training, education, transportation, job placement, assistive technology and other support services to people with disabilities. Visit site

Social Security Administration

Find answers and general information quickly about Social Security’s programs and procedures. Visit site

Centers for Medicare and Medicaid (CMS)

The Centers for Medicare & Medicaid Services, CMS, is part of the Department of Health and Human Services (HHS). Visit site

North Carolina Medicaid

Division of Medical Assistance (DMA) uses the resources and partnerships of Medicaid to improve health care for all North Carolinians. The DMA vision is to lead the transformation to a healthier North Carolina. Visit site

Department of Social Services (DSS)

The Division of Social Services provides guidance and technical assistance to agencies that provide direct services that address issues of poverty, family violence and exploitation. The Division promotes self-reliance and self-sufficiency, and to prevent abuse, neglect, dependency and exploitation of vulnerable individuals, children and their families. Visit site

* Maggie Shankle is Board Certified by the North Carolina State Bar as a Specialist in Workers’ Compensation Law. This puts her in an elite class of specialists who have met rigorous criteria including additional testing and display a superior understanding of Workers’ Compensation Law.